Healthcare Provider Details

I. General information

NPI: 1811296536
Provider Name (Legal Business Name): ELIEZER A. FROMMER, MD, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2011
Last Update Date: 10/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 PENNINGTON WAY
NEW HEMPSTEAD NY
10977-1418
US

IV. Provider business mailing address

31 PENNINGTON WAY
NEW HEMPSTEAD NY
10977-1418
US

V. Phone/Fax

Practice location:
  • Phone: 845-362-0527
  • Fax:
Mailing address:
  • Phone: 845-362-0527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number254437
License Number StateNY

VIII. Authorized Official

Name: DR. ELIEZER AARON FROMMER
Title or Position: OWNER
Credential: M.D.
Phone: 845-362-0527